Elevator Inspection Checklist Form PDF Details

An efficacious and thorough elevator inspection is critical for ensuring the safety, functionality, and compliance of elevator systems within buildings. The Elevator Inspection Checklist provides an exhaustive framework to evaluate various aspects of elevator or dumbwaiter units, including passenger and freight elevators, across a plethora of check points. Covering the inside of the car, machine room, top of the car, pit, outside the hoistway, and fire service operations, this form delineates items to be inspected under categories marked "OK" for satisfactory, "NG" for unsatisfactory, and "NA" for not applicable. Particular focus is given to the inspection of doors, operating controls, safety mechanisms, power systems, and emergency operations. The checklist further categorizes these inspections by type—periodic, acceptance, and others—while also requiring detailed information about the building and unit, such as the manufacturer, capacity, and speed. It is a comprehensive tool for inspectors to ensure that all statutory safety and operational standards are met, thereby safeguarding the well-being of elevator users and maintaining the longevity of the elevators themselves. Revised on February 10, 2011, this form also includes fields for inspection company and inspector information, enhancing accountability in the inspection process.

QuestionAnswer
Form NameElevator Inspection Checklist Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesElevator Safety Inspection Checklist Form, DA Form 7485-R

Form Preview Example

Checklist - Elevator or Dumbwaiter Inspection

Unit Type

Dumbwaiter

Passenger Elevator

 

 

Freight Elevator

 

 

 

Inspection Type

Periodic

Acceptance

 

 

 

Building and Unit Information

Building Name

 

 

 

Unit Identification:

 

 

 

 

 

 

 

 

 

 

Address

 

Chicago, IL

Manufacturer

 

 

 

 

 

 

 

 

 

 

 

 

Phone No.

 

 

 

Speed

 

 

 

fpm

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Building Representative

 

 

 

Capacity

 

 

lbs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. ELEVATOR-INSIDE OF CAR

OK

NG

NA

2. ELEVATOR MACHINE ROOM (cont.)

OK

NG

NA

1.1

Door reopening device

 

 

 

2.24

 

(T) AC drives from a DC source

 

 

 

1.2

Stop switches

 

 

 

2.25

 

(T) Traction sheaves

 

 

 

1.3

Operating control devices

 

 

 

2.26

 

(T) Secondary & deflector sheaves

 

 

 

1.4

Sills & car floor

 

 

 

2.27

 

(T) Rope fastenings

 

 

 

1.5

Car lighting & receptacles

 

 

 

2.28

 

(T) Terminal stopping devices

 

 

 

1.6

Car emergency signal-lighting

 

 

 

2.29

 

(T) Car & counterweight safeties

 

 

 

1.7

Car door or gate

 

 

 

2.30

 

(H) Hydraulic power unit

 

 

 

1.8

Door closing force

 

 

 

2.31

 

(H) Relief valves

 

 

 

1.9

Power closing of doors or gates

 

 

 

2.32

 

(H) Control valve

 

 

 

1.10

Power opening of doors or gates

 

 

 

2.33

 

(H) Tanks

 

 

 

 

Car vision panels & glass car doors

 

 

 

2.34

 

(H) Flexible hydraulic hose & fitting

 

 

 

1.11

 

 

 

 

assemblies

 

 

 

 

 

 

 

 

 

 

 

 

1.12

Car enclosure

 

 

 

2.35

 

(H) Supply line & shutoff valve

 

 

 

1.13

Emergency exit

 

 

 

2.36

 

(H) Hydraulic cylinders

 

 

 

1.14

Ventilation

 

 

 

2.37

 

(H) Pressure switch

 

 

 

1.15

Signs & operating device symbols

 

 

 

2.38

 

(H) Roped water hydraulic elevators

 

 

 

1.16

Rated load, platform area, & data plate

 

 

 

2.39

 

(H) Low oil protection

 

 

 

1.17

Standby power operation

 

 

 

2.40

 

Inspection control

 

 

 

1.18

Restricted opening of car or hoistway doors

 

 

 

2.41

 

Maintenance records

 

 

 

1.19

Car Ride

 

 

 

2.42

 

Static control

 

 

 

2. ELEVATOR-MACHINE ROOM

OK

NG

NA

3. ELEVATOR-TOP OF CAR

OK

NG

NA

2.1

Access to machine space

 

 

 

3.1

 

Top-of-car stop switch

 

 

 

2.2

Headroom

 

 

 

3.2

 

Car top light & outlet

 

 

 

2.3

Lighting & receptacles

 

 

 

3.3

 

Top-of-car operating device

 

 

 

2.4

Machine space

 

 

 

3.4

 

Normal terminal stopping devices

 

 

 

2.5

Housekeeping

 

 

 

3.5

 

Clearance, refuge space standard railing

 

 

 

2.6

Ventilation

 

 

 

3.6

 

Final & emergency terminal stopping devices

 

 

 

2.7

Fire extinguisher

 

 

 

3.7

 

Car leveling & anti-creep devices

 

 

 

2.8

Pipes, wiring, & ducts

 

 

 

3.8

 

Top emergency exit

 

 

 

2.9

Guarding of exposed auxiliary equipment

 

 

 

3.9

 

Floor & emergency identification numbering

 

 

 

2.10

Numbering of elevators,machines,disconnects

 

 

 

3.10

 

Hoistway construction

 

 

 

2.11

Disconnecting means & control

 

 

 

3.11

 

Hoistway smoke control (IDPH only)

 

 

 

2.12

Controller wiring, fuses, grounding, etc.

 

 

 

3.12

 

Pipes, wiring & ducts

 

 

 

2.13

Governor, overspeed switch, & seal

 

 

 

3.13

 

Windows, projections, recesses, & setbacks

 

 

 

2.14

Code data plate

 

 

 

3.14

 

Hoistway clearances

 

 

 

2.15

(T) Static control

 

 

 

3.15

 

Multiple hoistways

 

 

 

2.16

(T) Overhead beam & fastenings

 

 

 

3.16

 

Traveling cables & junction boxes

 

 

 

2.17

(T) Drive machine brake

 

 

 

3.17

 

Door & gate equipment

 

 

 

2.18

(T) Traction drive machines

 

 

 

3.18

 

Car frame & stiles

 

 

 

2.19

(T) Gears, bearings, & flexible coupling

 

 

 

3.19

 

Guide rails fastening & equipment

 

 

 

2.20

(T) Winding drum mach & slack cable dev

 

 

 

3.20

 

Governor rope

 

 

 

2.21

(T) Belt or chain-drive machine

 

 

 

3.21

 

Governor releasing carrier

 

 

 

2.22

(T) Motor generator

 

 

 

3.22

 

Wire rope fastening & hitch plate

 

 

 

2.23

(T) Absorption of regenerated power

 

 

 

3.23

 

Suspension rope

 

 

 

Checklist - Elevator or Dumbwaiter Inspection

 

 

 

 

 

 

 

(Continuation)

Unit ID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. ELEVATOR-TOP OF CAR (cont.)

OK

NG

NA

 

 

5. ELEVATOR-PIT

OK

NG

NA

3.24

(T) Top counterweight clearance

 

 

 

5.1

 

Pit access, lighting, stop switch, & condition

 

 

 

3.25

(T) Car, overhead, & deflector sheaves

 

 

 

5.2

 

Bottom clearance, runby & min. refuge space

 

 

 

 

(T) Broken rope, chain, or tape switch

 

 

 

5.3

 

(T) Final & emergency terminal stopping

 

 

 

3.26

 

 

 

 

devices

 

 

 

 

 

 

 

 

 

 

 

 

 

3.27

Crosshead data plate & rope data tags

 

 

 

5.4

 

Normal terminal stopping devices

 

 

 

3.28

Counterweight & counterweight buffer

 

 

 

5.5

 

Traveling cables

 

 

 

3.29

Counterweight safeties

 

 

 

5.6

 

Governor-rope tension devices

 

 

 

3.30

(H) Speed test

 

 

 

5.7

 

Car Frame & platform

 

 

 

 

(H) Slack rope device – roped-hydraulic

 

 

 

5.8

 

Car safeties & guiding members - including

 

 

 

3.31

elevators (*)

 

 

 

 

roped-hydraulic elevators (*)

 

 

 

 

 

 

 

 

 

 

 

 

(H) Traveling sheave – roped-hydraulic elevators

 

 

 

5.9

 

(T) Buffers & emergency terminal speed

 

 

 

3.32

(*)

 

 

 

 

 

limiting devices

 

 

 

 

 

 

 

 

 

 

 

 

3.33

(T) Compensating ropes & chains

 

 

 

5.10

 

(T) Compensating chains, ropes & sheaves

 

 

 

4. ELEVATOR-OUTSIDE HOISTWAY

OK

NG

NA

5.11

 

(H) Plunger & cylinder

 

 

 

4.1

Car platform guard

 

 

 

5.12

 

(H) Car buffer

 

 

 

4.2

Hoistway doors

 

 

 

5.13

 

(H) Guiding members

 

 

 

4.3

Vision panels

 

 

 

5.14

 

(H) Supply piping

 

 

 

4.4

Hoistway door locking devices

 

 

 

6. ELEVATOR-FIRE SERVICE

OK

NG

NA

4.5

Access to hoistway

 

 

 

6.1

 

Phase I Operation

 

 

 

 

4.6

Power closing of hoistway doors

 

 

 

6.2

 

Phase II Operation

 

 

 

4.7

Sequence operation

 

 

 

6.3

 

FAID (Fire Alarm Initiating Device) Operation

 

 

 

4.8

Hoistway enclosure

 

 

 

OK – meets requirement

 

 

 

4.9

Elevator Parking devices

 

 

 

NG – No Good (Insert number to identify comment on form)

 

4.10

Emergency doors in blind hoistways

 

 

 

NA – not applicable

 

 

 

4.11

(T) Separate counterweight hoistway

 

 

 

(T) – Traction Elevators only

 

 

 

4.12

Standby power selection switch

 

 

 

(H) – Hydraulic elevators only

 

 

 

4.13

Inspection control

 

 

 

(*) -

installed under A17.1b-1989 and later editions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Item

 

Comment

 

 

 

 

 

 

 

Code

 

 

No.

 

 

 

 

 

 

 

 

Reference

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Inspection Status:

 

 

Inspection Company & Inspector’s Information

 

 

 

 

 

 

 

Company Name

Date of Inspection:

 

 

 

 

 

 

Street Address

Code Edition:

 

 

 

 

FAIL

 

City, State, Zip

 

 

 

 

 

 

 

 

 

 

Inspector QEI #

 

 

Permit Req'd

 

 

PASS

 

Inspector’s State License #

 

 

 

 

 

 

 

 

 

 

Inspector’s Signature:

 

 

 

 

Revised 2-10-2011

Page 2 of 2

 

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This document will involve some specific details; to guarantee accuracy and reliability, please make sure to bear in mind the tips below:

1. To begin with, when completing the DA Form 7485-R, beging with the form section that contains the next blanks:

Writing section 1 of Elevator Inspection Checklist Form

2. Soon after this part is done, proceed to type in the applicable information in all these - NA ELEVATOR MACHINE ROOM cont cid, H Control valve, H Tanks H Flexible hydraulic hose, cid, OK NG NA cid cid cid cid cid cid, cid cid cid cid cid cid cid cid, cid, cid, cid, Power closing of doors or gates, Power opening of doors or gates, Car vision panels glass car doors, Car enclosure, Emergency exit, and Ventilation.

Learn how to complete Elevator Inspection Checklist Form stage 2

3. Through this part, take a look at T Static control, T Overhead beam fastenings, T Drive machine brake, T Traction drive machines, T Gears bearings flexible coupling, T Winding drum mach slack cable, T Belt or chaindrive machine, T Motor generator T Absorption of, cid cid cid cid cid cid cid cid, cid cid cid cid cid cid cid cid, cid Hoistway construction cid, Traveling cables junction boxes, Door gate equipment, Car frame stiles, and Suspension rope. All of these are required to be taken care of with highest accuracy.

Elevator Inspection Checklist Form completion process shown (portion 3)

4. The fourth section comes next with these blank fields to fill out: Checklist Elevator or Dumbwaiter, Continuation, Unit ID, ELEVATORPIT, OK NG NA cid cid Pit access, cid cid, cid, cid, cid, Normal terminal stopping devices, Traveling cables, Governorrope tension devices, Car Frame platform Car safeties, cid cid cid cid, and cid.

OK NG NA cid cid Pit access, Continuation, and ELEVATORPIT of Elevator Inspection Checklist Form

Be very mindful when filling in OK NG NA cid cid Pit access and Continuation, since this is the section in which a lot of people make mistakes.

5. The form needs to be wrapped up by filling in this area. Here one can find a full set of form fields that require specific information for your document usage to be complete: Item No, Comment, Code Reference, Inspection Status, Inspection Company Inspectors, Date of Inspection, Code Edition, FAIL cid, cid, Permit Reqd, PASS cid, Company Name, Street Address, City State Zip, and Inspector QEI.

Filling out segment 5 of Elevator Inspection Checklist Form

Step 3: Before moving forward, make sure that all blanks were filled out properly. The moment you’re satisfied with it, click “Done." Try a 7-day free trial plan at FormsPal and obtain direct access to DA Form 7485-R - downloadable, emailable, and editable in your FormsPal cabinet. FormsPal guarantees your data confidentiality by using a secure system that never saves or shares any type of sensitive information typed in. You can relax knowing your paperwork are kept safe when you work with our services!